Predictors of Job Satisfaction and Intent to Leave among Home Health Workers: An Analysis of the National Home Health Aide Survey. Multivariate Analyses: Intent to Leave

08/14/2015

Table 4 presents four models for intent to leave. The models differ in populations included and in the variables they contained. Models I, II, and III include all 119,500 weighted cases in the analytical sample. Model IV includes a smaller subset of the population, the 63,070 weighted cases that identify themselves as “somewhat satisfied” or “dissatisfied” with their job. Some variables in model IV had to be dropped due to small sample sizes for some levels among the not “extremely satisfied” population.

Job Satisfaction: Job satisfaction is strongly correlated with intention to leave even after controlling for worker characteristics, compensation, perceived workplace characteristics, job stressors and demands, and agency characteristics and policies in model II.

Worker Characteristics: Among aide characteristics, only household poverty status, age, and race are significantly correlated with intent to leave job. Aides with race of Black/African-American only have more than twice the odds of White only aides to intend to leave their jobs; however, among aides who are not extremely satisfied, the odds ratio does not achieve statistical significance. Workers below the age of 30 have higher odds of intending to leave, but only in model III, which excludes job satisfaction, is the result significant. Aides who have an income of 100-199 percent or 200-299 percent of the FPL are significantly less likely to intend to leave their jobs than households with incomes over 300 percent FPL.

Compensation: In model II, when controlling for job satisfaction, health insurance is correlated with lower intent to leave. In model III, when job satisfaction is excluded, workers in agencies with career ladder positions report significantly higher turnover intentions. Having a pension or retirement plan available did not affect intent to leave nor did wage levels.

Perceived Workplace Characteristics: In model III, which excludes job satisfaction, aides who reported feeling valued by their organizations and respected by their supervisors all had lower intention to leave. Working part-time and wanting more hours was significantly correlated with higher intent to leave compared to reporting “hours about right”. Either working part-time and wanting fewer hours or full-time and wanting more was associated with lower intention to leave. Having a consistent patient assignment was significantly associated with lower turnover intentions.

Job Stressors or Demands: Having had an injury in the past six months was consistently associated with higher intention to leave. In model III, which excludes job satisfaction, aides who reported having enough time for ADLs had lower intention to leave. Working more than one job was not correlated with intent to leave.

Agency Structures and Policies: Workers in for-profit chain-owned agencies are more than twice as likely to intend to leave their jobs as those in non-profit/other agencies; however, the odds ratio is not significant for the "not extremely satisfied" population (model IV). Reporting being encouraged to discuss patient care with patients’ families and the MSA status of an agency’s county were not significant.

Economic and Sociopolitical Factors: State unemployment rates were associated with higher intent to leave among aides who were not extremely satisfied (model IV), but were otherwise insignificant.

 

TABLE 4. Intent to Leave Logistic Regression Model

  Model I Entire Sample (OR) Model II Entire Sample (OR) Model III Entire Sample (OR) Model IV Not "Extremely Satisfied" (OR)
Weighted N: 119,500 119,500 119,500 63,070
Intercept 2.05* (1.11-3.79) 20.21* (1.85-220.49) 9.99 (0.94-106.27) 1.08 (0.10-11.26)
Job satisfaction Satisfied (REF=Dissatisfied) 0.04* (0.02-0.09) 0.05* (0.02-0.13)    
  Somewhat satisfied (REF=Dissatisfied) 0.20* (0.10-0.39) 0.16* (0.08-0.31)    
On-the-job injury in past 12 months Yes   2.41* (1.31-4.43) 2.44* (1.32-4.50) 2.85* (1.35-6.06)
Aide encouraged by agency to talk with patient's family Yes   1.22 (0.70-2.14) 1.05 (0.60-1.83) 1.15 (0.60-2.23)
Consistency of patient
assignment
Same patients (REF=combination)   0.24* (0.11-0.50) 0.26* (0.12-0.56) 0.15* (0.05-0.47)
Patients change (REF=combination)   0.52 (0.21-1.30) 0.57 (0.21-1.53) 0.44 (0.12-1.70)
Received formal training Yes   0.83 (0.34-1.99) 0.75 (0.34-1.69) 0.47 (0.21-1.08)
Career ladder positions available in agency for aides Yes   1.41 (0.77-2.58) 1.91* (1.06-3.45) 1.49 (0.69-3.21)
Health insurance offered at agency Yes   0.45* (0.23-0.87) 0.55 (0.25-1.20) 0.74 (0.33-1.69)
Pension or retirement plan
available at agency
Yes (REF=No)   1.02 (0.53-1.96) 0.68 (0.34-1.37) 0.6 (0.26-1.36)
Don't know (REF=No)   0.89 (0.25-3.24) 0.50 (0.10-2.43) 0.33 (0.06-1.78)
HHA feels valued by organization Very much (REF=Somewhat/ not at all)   0.54 (0.26-1.13) 0.34* (0.18-0.67)  
Aide feels involved in challenging
work
Strongly agree (REF=Somewhat/ strongly disagree)   0.62 (0.22-1.76) 0.37 (0.14-1.01)  
Somewhat agree (REF=Somewhat/ strongly disagree)   0.61 (0.19-1.94) 0.35* (0.12-0.98)  
Aide feels trusted with patient care
decisions
Strongly agree (REF=Somewhat/ strongly disagree)   0.52 (0.13-2.03) 0.42 (0.12-1.50)  
Somewhat agree (REF= REF=Somewhat/ strongly disagree)   0.47 (0.11-1.99) 0.35 (0.08-1.46)  
Time for ADLs More than enough time (REF=Enough time)   0.95 (0.52-1.73) 0.89 (0.46-1.72)  
Not enough time (REF=Enough time)   3.30 (0.88-12.36) 3.26* (1.18-8.98)  
Satisfaction with hours PT, want more hours (REF=Hours about right)   2.57* (1.13-5.85) 2.36* (1.03-5.44) 2.23 (0.81-6.18)
PT/fewer hours OR FT/more hours (REF=Hours about right)   0.36* (0.14-0.92) 0.45* (0.21-0.99) 0.37* (0.14-0.94)
FT, fewer hours (REF=Hours about right)   1.00 (0.30-3.36) 2.52 (0.70-9.05) 1.46 (0.36-5.88)
Aide feels respected by supervisor A great deal (REF=Somewhat or not at all)   1.42 (0.68-2.98) 0.86 (0.40-1.84) 0.69 (0.36-1.34)
Aide feels respected by patients A great deal (REF=Somewhat or not at all)   0.85 (0.42-1.72) 0.89 (0.44-1.79) 0.65 (0.30-1.39)
Aide's poverty status <100% FPL (REF=Over 300% FPL)   0.77 (0.36-1.65) 0.98 (0.44-2.19) 1.46 (0.52-4.08)
100-199% FPL (REF=Over 300% FPL)   0.34* (0.16-0.73) 0.41* (0.21-0.83) 0.43* (0.20-0.91)
200-299% FPL (REF=Over 300% FPL)   0.38* (0.17-0.87) 0.42* (0.19-0.95) 0.48 (0.18-1.24)
Aide the only worker in a household with dependent children Yes   0.71 (0.34-1.51) 0.59 (0.27-1.27) 0.66 (0.27-1.64)
Education <HS/GED (REF=Some college)   0.54 (0.18-1.68) 1.12 (0.42-2.99) 0.48 (0.15-1.52)
HS Grad or GED (REF=Some college)   0.93 (0.49-1.77) 0.94 (0.47-1.88) 0.87 (0.44-1.75)
Ownership Chain-affiliated for-profit (REF=Not-for-profit/other)   2.60* (1.35-5.02) 2.38* (1.30-4.38) 2.12 (0.92-4.87)
  Standalone for- profit (REF=Not-for-profit/other)   1.27 (0.61-2.65) 1.69 (0.88-3.23) 1.95 (0.83-4.60)
Aide works more than 1 job Yes   0.74 (0.39-1.42) 0.83 (0.44-1.56) 0.95 (0.51-1.80)
Age <30 (REF=55 and over)   2.69 (0.92-7.81) 2.96* (1.09-8.05) 2.59 (0.74-9.06)
30-54 (REF=55 and over)   1.61 (0.77-3.37) 1.68 (0.85-3.32) 1.89 (0.84-4.25)
Race Other (REF=White only)   0.91 (0.28-2.89) 0.93 (0.33-2.62) 1.43 (0.43-4.76)
Black only (REF=White only)   2.19* (1.18-4.06) 2.32* (1.27-4.25) 1.64 (0.79-3.40)
Hispanic/Latino Yes   0.92 (0.27-3.11) 0.79 (0.29-2.13) 0.57 (0.18-1.76)
MSA status of agency Neither (REF=Metropolitan)   0.70 (0.37-1.33) 0.63 (0.32-1.25) 0.69 (0.18-2.62)
Micropolitan (REF=Metropolitan)   1.19 (0.55-2.57) 1.12 (0.53-2.39) 0.6 (0.23-1.59)
Computed hourlywage   1.00 (0.92-1.06) 1.00 (0.94-1.07) 0.99 (0.93-1.05)
State Unemployment rate, 2007   1.10 (0.86-1.41) 1.05 (0.83-1.33) 1.54* (1.11-2.14)
2 Pseudo-R (Cox& Snell, 1989) 0.186 0.303 0.243 0.241

 

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